Individual
MRS. CYNTHIA EILEEN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
52 E BEVERLY PKWY, VALLEY STREAM, NY 11580-4205
(516) 599-2612
Mailing address
52 E BEVERLY PKWY, VALLEY STREAM, NY 11580-4205
(516) 599-2612
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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